Functional determinants and perceived barriers to cardiac rehabilitation as predictors of short-term hospital readmission in acute coronary syndrome: an observational longitudinal cohort study

Background This study investigated whether functional characteristics and barriers to cardiac rehabilitation (CR), assessed through the Cardiac Rehabilitation Barriers Scale (CRBS), predict 30-day hospital readmission following discharge for acute coronary syndrome (ACS).Methods Single-center, observational longitudinal study conducted at a cardiology hospital.At hospital discharge, participants underwent assessments of respiratory muscle strength (maximum inspiratory [MIP] and expiratory pressures [MEP]), handgrip strength (HGS-D), and functional capacity (6-minute walk distance [6MWD]). At 30 days post-discharge, patients completed the CRBS, encompassing four domains (perceived needs/healthcare factors, logistical factors, work/time conflicts, and comorbidities/functional status) and were evaluated for hospital readmission.Results A total of 320 patients (63.8% men, mean age 63.5 ± 11.3 years, median GRACE score 109 [range 63–173]) were included. After adjustment for confounders (age, sex, BMI, GRACE score, length of stay, and time since discharge), shorter 6MWD (OR = 0.981, 95%CI 0.968–0.994, p = 0.005), lower MEP (OR = 0.891, 95%CI 0.841–0.945, p < 0.001), and higher CRBS comorbidities/functional status scores (OR = 1.429, 95%CI 1.241–1.645, p < 0.001) were associated with increased odds of hospital readmission. Additionally, 6MWD was inversely associated with the CRBS sum score (β = −0.020, 95%CI −0.034 to −0.006, p = 0.005).Conclusion Functional impairments and perceived barriers to cardiac rehabilitation are significant predictors of 30-day hospital readmission in ACS patients. Early identification of at-risk individuals may enhance post-discharge care strategies and reduce readmission rates.